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Intake & Enrollment

Online Intake Form

Allowing you to complete our intake form from the comfort of your home.


Intake Form

This form will timeout after two hours, please allow yourself at least one hour to complete it. Inactivity and different web browsers may case an earlier timeout without warning, which will result in a loss of all data. If you experience timeout issues, please try a different web browser.

Intake Form

Contact CORE

Connect with our CORE Navigators to refer a client, enroll in services, or learn more about our programs.

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